The classic clinical manifestations of acute suppurative cholangitis were first described by Charcot in 1877 as a triad of fever(and chill),jaundice and right upper quadrant pain. In 1959,Reynolds and Dargan characterized acute suppurative cholangitis as a distinct clinical entity manifested by a clinical pentad of Charcot,s three signs plus shock and central nervous system depression.We have clinical analysis of acute suppurative cholangitis,218 cases who were admitted in Chonnam Hospital from Jan.1989 to Dec.1995.All cases were treated conservatively initially,and then delayed operation was performed when the patients were improved from the septic condition by cholangitis.
Central Nervous System ; Cholangitis* ; Humans ; Jeollanam-do ; Shock

Laparoscopic cholecystectomy has been popularized all over the world as the treatment of choice for unnecessory symptomatic or asymptomatic gall stones. Initially, this surgery was applied to limited indications, but nowadays the indications of the surgery have been expanded to include severe, inflamed, complicated patients with gall stones, which used to be thought of as contraindications in the past. Surgeon,s technical improvement and newly devised surgical instruments made it possible to expand the limit of surgical indications for laparoscopic cholecystectomy. However, anatomical disorientation due to severe inflammed gall bladder is still the drawback to the possible occurrence of laparoscopic bile duct injury and bleeding. We have a clinical analysis of 32 cases of laparoscopic cholecystectomy for acute cholecystitis or G.B.empyema, surgical time,safety and case were evaluated. Two patients were converted to open laparotomy because of intraoperative bile duct injury and anatomical disorientation by hepatic flexure colonic interposition. As a result, we suggest that even in patients with subphrenic abscess or bile peritonitis secondary to G.B.empyema could be the indications for the laparoscopic cholecystectomy if surgeon's ability or patient's condition allow it.
Bile ; Bile Ducts ; Cholecystectomy, Laparoscopic* ; Cholecystitis, Acute ; Cholelithiasis* ; Colon ; Gallstones ; Hemorrhage ; Humans ; Laparotomy ; Peritonitis ; Subphrenic Abscess ; Surgical Instruments ; Urinary Bladder

Seventy four children with mumps meningitis were hospitalized to Pediatric department, Hangyang University Hospital between May, and August, 1977. The clinical illness of these children were studied and the following results were obtained. 1. The incidental ratio to total inpatients was 1%. 2. The seasonal distribution was highest in summer, and the peak incidence in July(28%). 3. The sex incidence was more common in male(M:F=4:1). 4. According to age distribution, Children between 6 to and 8 years of age comprised 45.2% of alll studied cases. 5. The signs and symptoms of mumps meningitis on admission revealed vomiting, fever, neck stiffness, positive Kernig's sign etc. in order. 6. The symptoms and signs of meningitis were present in 5(7%) before salivary gland swelling, in 56(75%) after it, and in 13(18%) simultaneously. 7. Other salivary gland involvement without parotid gland swelling was relatively high in mumps meningitis compared with simple mumps. 8. Fever was normalized within 4th hospital day in 85% of cases. 9. On C.S.F. findings, the cell counts were elevated in all cases, protein was normal or slightly elevated and sugar was normal in all cases. 10. Average hospital days were 4 days. 11. All cases were completely recovered within 7th hospital day except a case of orchitis and a case of pancreatitis.
Age Distribution ; Cell Count ; Child ; Fever ; Humans ; Incidence ; Inpatients ; Male ; Meningitis ; Mumps* ; Neck ; Orchitis ; Pancreatitis ; Parotid Gland ; Salivary Glands ; Seasons ; Vomiting

Fistula ; Hemorrhage ; Humans ; Hygiene ; Maxilla ; Mucous Membrane ; Osteotomy ; Perfusion ; Prognosis ; Tooth, Nonvital ; Transplants ; Wounds and Injuries

No abstract available.
Phonation*

Inverted vesical papilloma is an uncommon, probably benign neoplasm with distinctive histologic features. It usually presents with hematuria and lower urinary tract obstruction due to hall-valve effect. We report a case of vesical inverted papilloma, which was proved histologically, causing lower urinary tract obstruction.
Hematuria ; Papilloma ; Papilloma, Inverted* ; Urinary Bladder* ; Urinary Tract

PURPOSE: Multidrug-resistant tuberculosis (MDR-TB) is an emerging threat to human beings. However, there is little data on the current status of MDR-TB in Korea. This study investigated the current status of MDR-TB in Korea using a survey of all the data from drug susceptibility tests (DST) performed across the country over the last three years. METHOD: The DST results between Jan. 2000 and Dec. 2002 from 7 laboratories, which were in charge of all antituberculous DSTs across the country as of March 2002, were collected and analyzed to determine the actual number of drug-resistant or MDR-TB patients, annual trend, degree and pattern of resistance against anti-TB drugs, etc. RESULTS: Six laboratories used the absolute concentration method for DST and one used the proportional method. 59, 940 tests had been performed over the 3 year study period. The number of DST performed annually was 18,071, 19,950, and 21,919 in 2000-2002, respectively. The number of resistant tuberculosis patients (resistant against at least one anti-TB drug) had increased by 16.9% from 6,338 in 2000 to 7,409 in 2002. The rate of resistant tuberculosis among all DST results was 35.1% in 2000, 34.5% in 2001, and 33.8% in 2002. The number of MDR-TB patients (resistant against at least both isoniazid and rifampin) showed an increasing trend (14.5%) from 3,708 in 2000 to 4,245 in 2002. CONCLUSION: Approximately 4,000 MDR-TB cases are newly identified by DST annually and the number is showing an increasing trend. This study suggests that in order to cope with the current MDR-TB situation, the DST methods will need to be standardized and more aggressive measures will be required.
Humans ; Isoniazid ; Korea* ; Tuberculosis ; Tuberculosis, Multidrug-Resistant*

Biliary cast describes the presence of casts within the biliary tree. It is resultant sequel of cholangitis and hepatocyte damage secondary to bile stasis and bile duct injury. Biliary cast syndrome was first reported in patient undergone liver transplantation. The pathogenesis of biliary cast is not clearly identified, but proposed etiologic factors include post-transplant bile duct damage, ischemia, biliary infection, or post-operative biliary drainage tube. Although biliary casts are uncommon, most of biliary cast syndrome are reported in the liver transplant or hepatic surgery patients. A few reports have been published about non-transplant or non-liver surgery biliary cast. We report two cases of biliary cast syndrome in non-liver surgery patients.
Acute Disease ; Ascariasis/diagnosis ; Bile Duct Diseases/*diagnosis/ultrasonography ; Bile Ducts/ultrasonography ; Cholagogues and Choleretics/therapeutic use ; Cholangiopancreatography, Endoscopic Retrograde/adverse effects ; Female ; Gallstones/diagnosis ; Humans ; Liver Cirrhosis, Biliary/diagnosis/drug therapy ; Male ; Middle Aged ; Pancreatitis/etiology ; Tomography, X-Ray Computed ; Ursodeoxycholic Acid/therapeutic use

BACKGROUND: Myoclonic movement is a common problem during induction of anesthesia with etomidate. We investigated the influences of pretreatment with remifentanil on etomidate induced myoclonus. METHODS: Ninety ASA class I patients were divided randomly into three groups. Group NS received normal saline 2 ml as placebo (n = 30), group R0.5 and group R1.0 were pretreated with remifentanil 0.5 microgram/kg (n = 30) or 1.0 microgram/kg (n = 30) 1 minute before induction with etomidate 0.3 mg/kg. Orotracheal intubation was performed after administration of rocuronium 0.5 mg/kg. We assessed the incidence, onset, duration and intensity of myoclonus. Mean arterial pressure (MAP), heart rate (HR) and bispectral index (BIS) were recorded during induction. RESULTS: Twenty five patients developed myoclonus in group NS (83.3%), 3 patients in group R0.5 developed myoclonus (10%), as did 5 patients in group R1.0 (16.7%). Moderate to severe myoclonus of grade 3 and 4 were found 66.7% of patients in group NS, whereas no patients in both remifentanil pretreated groups developed this grade of myoclonus. The duration of myoclonus was reduced significantly in the remifentanil groups: 93.8 +/- 59.5 sec in group NS, 49.3 +/- 34.9 sec in group R0.5, 36.0 +/- 27.0 sec in group R1.0 (P < 0.05). HR was decreased by pretreatment with remifentanil prior to induction, while MAP and HR were decreased after induction with etomidate (P < 0.05). BIS changes were not different among the three groups. The dose dependent differences between the two remifentanil doses were not noticed. CONCLUSIONS: Pretreatment with remifentanil significantly reduced the incidence, duration and intensity of etomidate induced myoclonus.
Androstanols ; Anesthesia ; Arterial Pressure ; Etomidate ; Heart Rate ; Humans ; Incidence ; Intubation ; Myoclonus ; Piperidines

We describe a case of cement leakage from the pedicle of vertebrae to the subcutaneous tissue after kyphoplasty.We attempted to remove all cement leakage, but residual cement remained in the paraspinal tissue without any neurological complications.This case illustrates the importance of the right timing of cement injection and when to detach the bone-filler device from the cement.
Kyphoplasty ; Spine ; Subcutaneous Tissue